Maryam Valapour, MD, is an Assistant Professor of Medicine in the Pulmonary and Critical Care Division;and Center for Bioethics, University of Minnesota (UM). Her research focuses on policies that govern the national distribution of lungs for transplantation therapy of end stage lung diseases. The institutional environment at UM provides very strong support through the UM Lung Transplant Program (one of the world s most active, and one of very few that currently perform living donor (LD) lung transplants) and the Center for Bioethics, which has an active interest in ethical issues related to LD organ transplantation. This proposal is designed to: 1) promote Dr. Valapour s development as a scholar in the field of lung transplantation ethics and policymaking by extending her prior training in pulmonary medicine and bioethics, and by adding formal training in health policy and clinical research methodologies. This will give her additional skill sets to become an independent researcher in the area of LD organ transplantation outcome assessment and policy development;and 2) inform the policy debate regarding LD lung transplantation. LD lung transplantation offers the only therapy for the many individuals unlikely to survive until a deceased organ becomes available. The research program of this grant will identify barriers that have prevented LD lung transplantation from becoming widely available by comparing it to the more widely practiced enterprise of LD kidney transplantation. The specific aims of this proposal are to: 1) Compare perceptions about LD transplantation of lungs versus kidneys in key stakeholder groups, including recipients, donors (related or non-related), nondonating family/friends, and transplant professionals;2) Compare policies and practices related to LD transplantation of lungs versus kidneys at a group of institutions that currently perform, stopped performing, and never performed LD lung transplantation (Aim 2A). Using the information from Aims 1 and 2A, she will develop policy recommendations for improvement of LD lung transplantation (Aim 2B). These aims will be accomplished by utilizing quantitative and qualitative data collection and analyses, along with ethical and policy analyses, thereby putting into use the new knowledge acquired during didactic components of this training program.